MHA 710 - Healthcare Economics - Exam 3 Questions And Answers

MHA 710 - Healthcare Economics - Exam
3 Questions And Answers
2.rIfrthermarketrwererperfectlyrcompetitiverinsteadrofrdominatedrbyrarmonopsonist,rwhatrwo
uldrtherequilibriumrwagerandrlevelrofremploymentrbe?
a.rW1randrE1
b.rW2randrE0
c.rW0randrE0
d.rW0randrE1
e.rW0randrE2r-rCORRECTrrANSWER-a.rW1randrE1

Arclassificationrsystemrforrphysicians'rservices,rusingrarweightingrschemerthatrreflectsrtherr
elativervaluerofrthervariousrservicesrperformed.rDevelopedrforrMedicarerbyrargrouprofrHarva
rdrresearchers,ritrconsidersrtime,rskill,randroverheadrcostrrequiredrforreachrservice.rWhenru
sedrinrconjunctionrwithrarmonetaryrconversionrfactor,rmedicalrfeesrarerdetermined.r-
rCORRECTrrANSWER-Resource-basedrrelativervaluerscaler(RBRVS)




Arcompilationrofrhospitalrspecificrchargesrforrallritemsrthatrtherhospitalrcanrbillrtorpatients,rins
urancerplans,randrotherrpayers.rTherlistrincludesrallrprocedures,rservices,rdrugs,randrtestsrt
hatrarerperformedratrtherfacility.r-rCORRECTrrANSWER-Chargemaster

Arcongressionallyrmandatedrschemertorclassifyroutpatientrservicesrintorclinicallyrsimilarrpro
cedures.r-rCORRECTrrANSWER-Ambulatoryrpaymentrclassificationr(APC)

Arfinancialrmeasurerofrarfirm'srabilityrtorgeneraterafter-
taxrprofitroutrofritsrtotalrsales.rCalculatedrbyrdividingrafter-taxrprofitrbyrtotalrsales.r-
rCORRECTrrANSWER-Returnronrsales




Argoodrthatrisrnon-rivalrinrdistributionrandrnon-exclusiverinrconsumptionr-
rCORRECTrrANSWER-Publicrgood




Arguaranteerthatrallrcitizensrwillrhaverhealthrinsurancercoveragerregardlessrofrincomerorrhe
althrstatus.rCoveragerusuallyrrequiresrmandatoryrparticipation.r-rCORRECTrrANSWER-
Universalrcoverage

,Arlimitronrtotalrspendingrforrargivenrtimerperiodr-rCORRECTrrANSWER-Spendingrcap

Arlinearrpricingrschemerwhererpricesrtordifferentrcustomersrarercomputedrbasedronrindividu
alrpricerelasticityrofrdemand.rCustomersrwithrarhighrwillingnessrtorpayrarerchargedrhigherrpri
ces.r-rCORRECTrrANSWER-Ramseyrpricing

ArMedicarerpolicyrprovidingrphysiciansrwithrarguaranteedrpaymentrofr80%rofrtherallowablerf
ee.rByraccepting,rphysiciansragreertoracceptrtherallowablerfeerasrfullrpaymentrandrforgorther
practicerofrbalancedrbilling.r-rCORRECTrrANSWER-Assignment

Armonetaryrvaluerusedrtortranslaterrelativervaluerunitsrintordollarramountsrtordeterminerarfee
rscheduler-rCORRECTrrANSWER-Monetaryrconversionrfactor




Arphysicianrwhoragreesrtoracceptrmedicarerassignment.r-rCORRECTrrANSWER-
Participatingrphysician

Arpricerceilingrsetrtorlimitrfeesrtortherminimumrofrtherbilledrcharge,rtherpricercustomarilyrchar
gedrbyrtherprovider,randrtherprevailingrchargerinrthergeographicrregionr-
rCORRECTrrANSWER-Usual,rcustomary,randrreasonabler(UCR)rcharges




Arpricingrschemerinrwhichrarpercentagerprofitrisraddedrtortheraveragercost.r-
rCORRECTrrANSWER-Cost-plusrpricing




Arprimaryrcarerphysicianrwhordirectsrhealthrcarerdeliveryrandrdeterminesrwhetherrpatientsr
arerallowedraccessrtorspecialtyrcarer-rCORRECTrrANSWER-Gatekeeper

ArpublicrhealthragencyrchargedrwithrprotectingrAmericanrconsumersrbyrenforcingrfederalrp
ublicrhealthrlaws.rFood,rmedicine,rmedicalrdevices,randrcosmeticsrarerunderrtherjurisdiction
rofrthisragency.r-rCORRECTrrANSWER-FoodrandrDrugrAdministrationr(FDA)




Arsituationrinrarproductionrprocessrwhererlong-
runraveragercostsrdeclinerasroutputrexpandsr-rCORRECTrrANSWER-Economiesrofrscale

Arspecificrpracticerrequiredrofrallrparticipatingrphysicians,rsuchrasrarpolicyrtorreferrpatientsro
nlyrtorarspecificrpanelrofrspecialistsr-rCORRECTrrANSWER-Clinicalrrule

ArsupplementalrinsurancerpolicyrsoldrtorMedicare-
eligiblerindividualsrtorpayrtherdeductiblesrandrcoinsurancerthatrarernotrcoveredrbyrMedicare
.r-rCORRECTrrANSWER-Medigaprinsurance

ArtyperIrerrorris:
a.rwhenrarbeneficialrdrugrisrblockedrfromrenteringrarmarket.
b.rtherstatisticalrnotionrofracceptingrarfalserhypothesis.
c.rwhenrarharmfulrdrugrisrallowedrintorthermarket.

, d.rdifficultrtordetectrandrvirtuallyrignoredrbyrtherFoodrandrDrugrAdministrationr(FDA).r-
rCORRECTrrANSWER-c.rwhenrarharmfulrdrugrisrallowedrintorthermarket.




AccordingrtorsurveysrbyrtherMedicalrGrouprManagementrAssociation,rtheraveragerprimaryr
carerphysicianrearnedrapproximatelyr_______rinr2010.
a.r$125,000
b.r$150,000
c.r$185,000
d.r$200,000
e.r$225,000.r-rCORRECTrrANSWER-d.r$200,000

Anrindexrthatrassignsrweightsrtorvariousrmedicalrservicesrusedrtordeterminertherrelativerfee
srassignedrtorthemr-rCORRECTrrANSWER-Relative-valuerscaler(RVS)

Anrinsurancerpremiumrbasedronrtheractuarialrprobabilityrthatranreventrwillroccur.r-
rCORRECTrrANSWER-Actuariallyrfairrpremium




Billingrarpatientrforrtherdifferencerbetweenrtherphysician'srusualrchargerforrarservicerandrther
maximumrchargerallowedrbyrtherpatient'srhealthrplan.r-rCORRECTrrANSWER-
Balancerbilling

Byrthertimerardrugrentersrtherclinicalrtrialrphaserofrtestingronrhumans,
a.ritsrapprovalrisrvirtuallyrassured.
b.ranraveragerofrfiveryearsrofrtheroverallrpatentrliferhasralreadyrexpired.
c.ritrhasralreadyrcompletedrmostrofrtherinvestmentrinrresearchrandrdevelopment.
d.ritsrsafetyrandreffectivenessrarernorlongerrmajorrconcerns.
e.rtheronlyrsteprleftrinrtherprocessrisrtestingrtorseerifrtherdrugraccomplishesritsrintendedrpurpo
se.r-rCORRECTrrANSWER-EITHERr-r
a.ritsrapprovalrisrvirtuallyrassured
orr
b.ranraveragerofrfiveryearsrofrtheroverallrpatentrliferhasralreadyrexpired

Changesrcausedrbyrthershiftrfromrcharge-
basedrratesrtornegotiatedrratesrhasrhadrwhichrofrtherfollowingrresults?
a.rChargingrmasterrratesrserverasrarpowerfulrguiderforroptimalrresourcerallocationrinrtherind
ustry.
b.rTherchangerhasrincreasedrtherimportancerofrRamseyrpricingrprinciplesrinrsettingrrates.
c.rMostrhospitalsrexperiencerargaprbetweenrtheramountrtheyrreceiverfromrtheirrpayersrandrt
heramountrbilled,rwithrreceiptsrasrlowrasr20rpercentroframountrbilled.
d.rArgrowingrpercentagerofrpatientsrwithrinsurancerarerpayingrbilledrrates.r-
rCORRECTrrANSWER-

c.rMostrhospitalsrexperiencerargaprbetweenrtheramountrtheyrreceiverfromrtheirrpayersrandrt
heramountrbilled,rwithrreceiptsrasrlowrasr20rpercentroframountrbilled.

Comparedrtorthernot-for-profitrorganizationalrform,rtherfor-profitrenvironment
a.rallowsrforrthertransferrofrassets.